Percutaneous stent implantation into coronary arteries in infants

Abstract

Our experience suggests that coronary artery stent implantation is a feasible and relatively safe palliative option in infants and toddlers with coronary stenosis. It is a viable strategy for bridging patients with acute ischemia or poor ventricular function to elective surgical revascularization or transplantation.

Left main coronary artery stenting in a 3.6 kg infant after arterial switch operation for transposition of the great arteries

“…Percutaneous coronary artery stent implantation has not been extensively employed in the pediatric population[1] because of lack of appropriate equipment for such procedures and future growth of the patient and coronary. There are only a few case reports in the literature in infants less than 3 month of age, summarized in Table 1.…”

“…[1] We report successful left main coronary artery (LMCA) stenting in a 3.6 kilogram, 10-week-old infant with an unusual clinical presentation caused by critical, long-segment LMCA stenosis after arterial switch operation.…”

Percutaneous Coronary Intervention in Pediatric and Adolescent Patients

“…PCI in adults has been well studied and is known to reduce mortality associated with acute coronary syndrome and myocardial infarction . In contrast to adults, reasons for coronary compromise in children and adolescents are rare and yet more diverse, spanning from surgical complications to acquired diseases, such as Kawasaki disease and posttransplant coronary vasculopathy . Despite the diversity of procedural indications, the goals of PCI and techniques remain the same in either the adult or child: to relieve symptoms of angina, and to reverse or prevent ischemia, infarction, or sudden death .…”

“…Despite the diversity of procedural indications, the goals of PCI and techniques remain the same in either the adult or child: to relieve symptoms of angina, and to reverse or prevent ischemia, infarction, or sudden death . Available literature suggests that PCI is feasible from infancy to adolescence . Adult interventional expertise is often needed to perform percutaneous transluminal coronary angioplasty (PTCA), rotational ablation, and coronary stent placement in pediatric patients .…”

Left Main Coronary Artery Dissection in Pediatric Sport-Related Chest Trauma

“…These anatomic differences account for a higher rate of complications, such as temporary occlusion, thromboembolic events, rupture, and dissection (10). Because the use of larger implanted stents is associated with a lower rate of in-stent restenosis, older patients, like ours, are more appropriate candidates for this intervention (11). Adherence to an antiplatelet regimen is of utmost importance, as well as close interval monitoring of stent patency after these interventions.…”